The present invention relates to an improved anchor for securing laparoscopic instruments within puncture openings during surgery. In its more specific aspects, the invention is concerned with a balloon anchor adapted to be secured to the outside surface of virtually any laparoscopic instrument, without the necessity of modifying the structure of the instrument.
Laparoscopic surgery provides a minimally invasive approach to a wide variety of surgical procedures in, for example, the abdominal and thoracic cavities. In a minimally invasive approach, small incisions are made to provide access for instruments needed to perform surgery. The instruments, such as trocars, endoscopes, clip appliers, cautery devices and other tools, are commonly inserted through these small incisions using cannulas which are adapted to provide a pressure seal when using pneumoperitoneum. It is desirable to secure or anchor these cannulas into position in the incision to allow easy insertion and withdrawal of instruments through the cannula without corresponding movement of the cannula. Likewise, it is sometimes desirable to secure or anchor an instrument itself in an incision and prevent unwanted distal or proximal movement of the instrument.
Prior anchors for laparoscopic instruments have employed threaded sleeves adapted to be secured to the instruments and screwed into a laparoscopic puncture opening to secure the instrument in place. An anchor of this type is found in U.S. Pat. No. 5,217,441. Such anchors require a specific size for each size of instrument, since the sleeve must be of a configuration complemental to that of the instrument. The screw threads also must be twisted into place and are relatively traumatic.
The prior art also teaches adhesive anchors, sometimes called xe2x80x9cgrippers,xe2x80x9d for securing laparoscopic instruments in place within puncture openings. Such anchors employ a tubular boss configured to snugly engage the instrument and a flexible disk carried by the boss for adhesion to the outside surface of the punctured tissue. The boss must be specifically configured to match the configuration of the instrument being anchored. Blood emitting from the puncture opening often intrudes between the disk and the tissue so as to destroy the integrity of the anchor during surgery.
The prior art also teaches the provision of specially constructed laparoscopic cannula provided with inflatable balloons to anchor the cannula in place within a puncture opening. A cannula of this type may be seen in U.S. Pat. No. 5,002,557. Such cannula are expensive to fabricate and must be especially configured to match the instrument with which they are used.
It is also old in the art to anchor drainage catheters with balloons incorporated into the catheter. One well-known catheter of this type used for urinary drainage is the xe2x80x9cFoleyxe2x80x9d catheter. In such catheters, the balloon and the conduit provided for its inflation is integrally molded into the catheter.
The present invention is an improvement over the prior art in that it provides a universal balloon anchor which may be secured to the outside of a laparoscopic instrument and inflated to anchor the instrument in place within a puncture opening. The balloon is configured so as to have a low profile generally contiguous with the outside surface of the instrument to facilitate its low insertion force placement and removal, without significant trauma to the tissue defining a small laparoscopic opening.
In its broadest aspects, the anchoring system of the invention provides a low profile balloon adapted to be engaged with the outside surface of a laparoscopic instrument. In the preferred embodiments, the balloon is adhesively secured to the instrument. Certain embodiments also employ mechanical structure to constrain the balloon and hold it in place. Conduit means for inflating the balloon is also secured externally of the instrument being anchored.
In the method of the invention, the balloon is secured to the outer surface of an instrument to be anchored with the balloon in a deflated low profile configuration essentially contiguous with the outer surface of the instrument. The instrument is then extended through the puncture opening within which it is to be anchored so as to dispose at least a portion of the balloon to the inside of the opening. The balloon is then inflated to anchor the instrument.
A principal object of the invention is to provide a universal anchor which may be secured to virtually any instrument used for laparoscopic surgery to anchor the instrument within a puncture opening.
Another and related object is to provide such an anchor which is inexpensive and may be used with a minimum of trauma to the punctured tissue.
Yet another object of the invention is to provide such an anchor which can accommodate puncture openings formed in tissues of different wall thicknesses.
Still another object of the invention is to provide such an anchor which may form a seal around the puncture.
Still another and more specific object of the invention is to provide such an anchor which may lock the instrument against movement either into or out of a puncture opening.
A further object of the invention is to provide such an anchor which may be used for both gasless- and gas-(insufflation) type laparoscopic surgery.
Another object of the invention is to provide such an anchor which may be located anywhere along the length of a laparoscopic instrument and which can be used in multiples, if desired.
Yet a further object of the invention is to provide such an anchor which is ideally suited for one-time use and does not have such bulk as to create undue disposal problems.
The foregoing and other objects will become more apparent when viewed in light of the following detailed description and accompanying drawings.